Overmedicated, Unwanted, Stigmatized, Powerless: America’s (Forgotten) Foster Children
As Sharon Hays, Loïc Wacquant, and others have shown, dominant cultural narratives dispersed via mass media, political campaigns, educational and religious institutions and the like play a significant role in constructing social identities—for example, the “welfare queen,” the “black” male criminal, etc. Such narratives, along with others downplaying social responsibility (and overemphasizing an ahistorical, race-less, gender-less individualistic picture of responsibility, which fail to take into account the genuine disparities of experience between, for example, whites and blacks in America) influence public policies in ways that are often unacknowledged or not taken seriously.
As both Hays and Wacquant observe, the 1996 Personal Responsibility Act assumes and is underwritten by negative stereotypes of welfare mothers as social outcasts and moral delinquents. Following the lead of the aforementioned sociologists, I hope to engage in a (future) research project investigating the ways in which adopted, foster, and institutionalized children are likewise socially stigmatized by political, religious, and other narratives and how this influences legislation, family placement (i.e., what kind of families are considered as ideal, which are excluded and why), and long-term child development.
In addition, drawing from my dissertation research on Foucauldian power relations and socially constructed subjectivities, I imagine such a project unfolding via an analysis of the impact of certain medical practices and categorizations imposed upon institutionalized children (e.g., how do labels such as “mildly,” “moderately,” or “severely developmentally and emotionally challenged” influence or put pressure on children to take certain medicines and undergo certain psychological therapies with which they are uncomfortable?). Many children in foster care have reported that they experienced sexual, physical, and emotional abuse both in state care and at the hands of their foster parents. Some of this abuse included being overmedicated. For example, in a 2004 study of a random sample of 472 medicated youth in foster care in aTexas facility ages 0 through 19 years, the disturbing findings are as follows:
Of the foster children who had been dispensed psychotropic medication, 41.3% received ≥3 different classes of these drugs during July 2004, and 15.9% received ≥4 different classes. The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%). The use of specific psychotropic medication classes varied little by diagnostic grouping. Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of ≥2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly.
The overall conclusion of this study was that “[c]oncomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.” Why then are these children being overmedicated? What is being done to prevent such abuse? Provocatively put, are these children being used as human lab rats? What resistance possibilities are available to these children given the asymmetrical power relations involved? (Just today I read this story in The Children’s Monitor, a publication of the Child Welfare League of America, confirming the abuse and overmedication of children in state care. For example, the article states that the children are given “doses that are too high”—some children were found to be on more than five medications simultaneously! In addition, children under age one were given high-powered prescription drugs, and given the multiple caregivers, the unstable state supervision, and lax regulations, the medicines prescribed are improperly monitored, which often results in “gaps in prescribed regimens.” By clicking the following link, Giovan Bazan’s Story of Twelve Years of Overmedication in Foster Care, you can listen to one young man’s story of his own person experience with overmedication the foster care system. He is now an advocate for children in state care.)
Additional problems with this complex nexus of the state, children, and foster families include proper screening of foster parents. How can we prevent foster parents from simply using the system for the remuneration they receive from the state? Why do so many children to suffer abuse in their foster families? If new legislation, innovative practices, or other models are helping in any of these areas, how might we make these “tools” available nationwide?
Besides drawing from the insights of sociologists, critical “race” theory, and moral philosophy, I want to consider the contributions faith-based communities might have to offer with respect to re-imagining and creating more positive, affirming, and inclusive views of adoption and foster care, while also exploring the ways that certain narratives in these traditions—for example, narratives overemphasizing the biological family as the ideal family—have actually cultivated and helped to shape negative and stigmatized views of adopted and foster children and families. This is both ironic and unfortunate because many of these traditions have rich theological and ethical resources to offer with respect to a more diverse and difference-affirming view of families.
Wacquant has argued that there is an intimate connection between U.S.prisons and welfare/workfare. The former overpopulated with African American males—the special targets of a neoliberal state practicing laissez-faire policies toward the top social strata and punitive paternalistic intervention toward the lower social strata—and the latter often constituting socially stigmatized wives, girlfriends, and children of these inmates. Just as Wacquant has discovered structural similarities between prison-fare and welfare/workfare, perhaps there are additional structural commonalities to be found in relation to child welfare institutions. Here my interdisciplinary study might include an examination of the architectural spaces in which these children live, paying attention to how such spaces impact a child’s emotional, intellectual, and physical development and well-being. My findings could then lead to new proposals with respect to implementing aesthetic and other improvements that serve and advance the welfare of institutionalized children.
Economic systems and the narratives they employ, as well as the ethos they produce must also be considered. As Margaret R. Somers and Fred Block have argued, American culture breathes market-driven air, and as a result “market fundamentalism” has played a leading role in reshaping how our society views welfare. Similar to Wacquant’s and Hay’s conclusions, these scholars emphasize how new narratives are created that ignore or downplay larger historical, sociopolitical, and structural factors (such as systemic “racism” or “racial” bias). As a result, poor people are often unjustly constructed and construed as criminal, perverse, and the only ones to blame for their condition. For example, women who bear children out of wedlock are depicted as morally deficient and thus responsible for the burden they must bear. If a woman in this condition turns to welfare, the dominant “poverty to perversity” narrative depicts her as lazy, debauched, and overly reliant on the state and the “real” work of responsible citizens. Certain religious narratives likewise enter the picture, criticizing these women for abandoning their children for the workplace or for not being able to find a “respectable” mate. Given the current anti-welfare ethos in theU.S., how might we begin to recreate a more positive, compassionate view of social welfare? Part of the re-form process—whether reforming legislative policies or re-forming the American imagination—is to raise public awareness of the structural “racial,” “gender,” and class disparities in place in American society, all of which produce tremendous challenges for impoverished women and children.
 See, for example, Michelle Cole, “Abuse in children’s foster care: State officials call for outside review.” Oregonian. Published, Sept. 2, 2009; accessed Oct. 15, 2011: http://www.oregonlive.com/politics/index.ssf/2009/09/abuse_in_foster_care_state_off.html.
 Julie M. Zito, Daniel J. Safer, Devadatta Sai, et al., “Psychotropic Medication Patterns Among Youth in Foster Care,” Pediatrics (2008), e157. (The online version of this article, along with updated information, can be accessed at: http://pediatrics.aappublications.org/content/121/1/e157.full.html).
 See, for example, Margaret R. Somers and Fred Block, “From Poverty to Perversity: Ideas, Markets, and Institutions over 200 Years of Welfare Debate,” American Sociological Review 70 (2005): 260–287.
 See, for example, Sharon Hays, Flat Broke with Children: Women in the Age of Welfare Reform , 231–35.